Rural Health
Resources by Topic: Reimbursement and payment models
The Future of the Frontier Extended Stay Clinic
Describes the Centers for Medicaid and Medicare Services (CMS) Frontier Extended Stay Clinic (FESC) demonstration project. Identifies the successes and challenges, and discusses the financial sustainability of the FESC model. Includes policy recommendations and lessons learned.
Author(s): Susan Wilger, Saskia Van Hecke
Date: 02/2014
Type: Document
Sponsoring organization: National Rural Health Association
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Describes the Centers for Medicaid and Medicare Services (CMS) Frontier Extended Stay Clinic (FESC) demonstration project. Identifies the successes and challenges, and discusses the financial sustainability of the FESC model. Includes policy recommendations and lessons learned.
Author(s): Susan Wilger, Saskia Van Hecke
Date: 02/2014
Type: Document
Sponsoring organization: National Rural Health Association
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The Extender Policies: What Are They and How Should They Continue Under a Permanent SGR Repeal Landscape
Provides resources from the U.S. House of Representatives Energy and Commerce Committee hearing on Medicare extender policies to determine whether they should be made permanent. Addresses payment adjustments for low-volume hospitals, rural areas, and more. Includes statements from the Rural Hospital Coalition, American Hospital Association, and National Rural Health Association on the impact of these payment policies on rural hospitals and rural beneficiaries.
Additional links: Statement of the American Hospital Association, Statement of the National Rural Health Association, Statement of the Rural Hospital Coalition, Transcript
Date: 01/2014
Type: Video/Multimedia
Sponsoring organization: House Energy and Commerce Committee, Subcommittee on Health
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Provides resources from the U.S. House of Representatives Energy and Commerce Committee hearing on Medicare extender policies to determine whether they should be made permanent. Addresses payment adjustments for low-volume hospitals, rural areas, and more. Includes statements from the Rural Hospital Coalition, American Hospital Association, and National Rural Health Association on the impact of these payment policies on rural hospitals and rural beneficiaries.
Additional links: Statement of the American Hospital Association, Statement of the National Rural Health Association, Statement of the Rural Hospital Coalition, Transcript
Date: 01/2014
Type: Video/Multimedia
Sponsoring organization: House Energy and Commerce Committee, Subcommittee on Health
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Indian Health Service: Opportunities May Exist to Improve the Contract Health Services Program
Examines the challenges involved with timely payments from the Indian Health Service's (IHS) Contract Health Services Program for the care of American Indians and Alaska Natives. Covers IHS's performance measures and other factors that impact the length of time between the provision of healthcare services and IHS Contract Health Services Program reimbursements to providers.
Additional links: Full Report
Date: 12/2013
Type: Document
Sponsoring organization: Government Accountability Office
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Examines the challenges involved with timely payments from the Indian Health Service's (IHS) Contract Health Services Program for the care of American Indians and Alaska Natives. Covers IHS's performance measures and other factors that impact the length of time between the provision of healthcare services and IHS Contract Health Services Program reimbursements to providers.
Additional links: Full Report
Date: 12/2013
Type: Document
Sponsoring organization: Government Accountability Office
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Assessing the Impact of Rural Provider Service Mix on the Primary Care Incentive Payment Program
Examines calendar year 2009 Medicare claims data to assess the impact of rural providers' service mix on Primary Care Incentive Payment Program (PCIP) qualifications and payments. Also estimates the financial impact of PCIP payments on rural providers, and evaluates whether the PCIP is fairly applied to rural and urban providers, whose service mixes are likely to differ. The PCIP program lasted from 2011-2015.
Author(s): Dan Shane, A. Clinton MacKinney, Fred Ullrich, Keith J. Mueller, Paula Weigel
Date: 12/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Examines calendar year 2009 Medicare claims data to assess the impact of rural providers' service mix on Primary Care Incentive Payment Program (PCIP) qualifications and payments. Also estimates the financial impact of PCIP payments on rural providers, and evaluates whether the PCIP is fairly applied to rural and urban providers, whose service mixes are likely to differ. The PCIP program lasted from 2011-2015.
Author(s): Dan Shane, A. Clinton MacKinney, Fred Ullrich, Keith J. Mueller, Paula Weigel
Date: 12/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Change in Profitability and Financial Distress of Critical Access Hospitals from Loss of Cost-Based Reimbursement
Examines how proposed changes to Critical Access Hospital (CAH) cost-based reimbursement would affect the financial vulnerability of CAHs. Uses models to forecast the financial impact of 20 and 30 percent reductions in Medicare revenue, and the resulting implications for rural healthcare access.
Author(s): Mark Holmes, George H. Pink
Date: 12/2013
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Examines how proposed changes to Critical Access Hospital (CAH) cost-based reimbursement would affect the financial vulnerability of CAHs. Uses models to forecast the financial impact of 20 and 30 percent reductions in Medicare revenue, and the resulting implications for rural healthcare access.
Author(s): Mark Holmes, George H. Pink
Date: 12/2013
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Dental Services: Information on Coverage, Payments, and Fee Variation
Describes trends in dental services coverage and payments, and the extent of variation in dental fees in selected communities. Appendix II includes statistics comparing dental visit rates in urban and rural areas.
Additional links: Full Report
Date: 09/2013
Type: Document
Sponsoring organization: Government Accountability Office
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Describes trends in dental services coverage and payments, and the extent of variation in dental fees in selected communities. Appendix II includes statistics comparing dental visit rates in urban and rural areas.
Additional links: Full Report
Date: 09/2013
Type: Document
Sponsoring organization: Government Accountability Office
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Rural Implications of Changes to the Medicare Hospice Benefit
Policy brief highlights an April 2013 meeting in Grand Junction, Colorado, of the National Advisory Committee on Rural Health and Human Services. Presents the committee's recommendations and analyses of ACA provisions which may have rural implications regarding challenges and innovations in hospice and palliative care in rural and frontier areas.
Date: 08/2013
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Policy brief highlights an April 2013 meeting in Grand Junction, Colorado, of the National Advisory Committee on Rural Health and Human Services. Presents the committee's recommendations and analyses of ACA provisions which may have rural implications regarding challenges and innovations in hospice and palliative care in rural and frontier areas.
Date: 08/2013
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Rural Implications of the Primary Care Incentive Payment Program
Reports on eligibility trends among urban and rural primary care providers for the Primary Care Incentive Payment (PCIP) established in the Affordable Care Act (ACA). Discusses reasons the current PCIP eligibility requirements may be harder for rural family medicine providers to meet.
Author(s): Fred Ullrich, Clinton MacKinney, Keith Mueller
Date: 06/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Reports on eligibility trends among urban and rural primary care providers for the Primary Care Incentive Payment (PCIP) established in the Affordable Care Act (ACA). Discusses reasons the current PCIP eligibility requirements may be harder for rural family medicine providers to meet.
Author(s): Fred Ullrich, Clinton MacKinney, Keith Mueller
Date: 06/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2013
Includes chapters on Medicare and ambulatory settings, bundling payments for post acute care, hospice, reducing hospital admissions, dual eligible beneficiaries, and Medicare payments for ambulance services, physicians, and outpatient therapy. Mentions rural throughout.
Date: 06/2013
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Includes chapters on Medicare and ambulatory settings, bundling payments for post acute care, hospice, reducing hospital admissions, dual eligible beneficiaries, and Medicare payments for ambulance services, physicians, and outpatient therapy. Mentions rural throughout.
Date: 06/2013
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Report to the Congress: Medicare Payment Policy, 2013
Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2013
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Discussions of rural aspects of Medicare payment policies are included throughout the report.
Date: 03/2013
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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